Use this URL to cite or link to this record in EThOS:
Title: Machine perfusion in kidney transplantation : clinical application & metabolomic analysis
Author: Guy, Alison Jane
ISNI:       0000 0004 5371 9721
Awarding Body: University of Birmingham
Current Institution: University of Birmingham
Date of Award: 2015
Availability of Full Text:
Access from EThOS:
Access from Institution:
Kidney Transplantation is the gold standard treatment for patients with end-stage renal failure. Most kidneys used for transplantation are from deceased donors and ensuring successful outcomes depends on many factors. One of these is organ storage. Hypothermic Machine Perfusion (HMP) of deceased donor organs has been shown to have several benefits. However, it has not been widely adopted and the underlying mechanism is poorly understood. The first section of this thesis examines the introduction of HMP into clinical practice. HMP outcomes were similar to those of standard storage techniques but with the additional benefit of increasing safe storage times. This was likely due to inherent benefits of the machine itself, improved recipient preparation and better peri-operative conditions. The second part of this study analysed HMP perfusate using metabolomics (Nuclear Magnetic Resonance) to identify potential predictors of graft outcome. Differences were identified in the metabolic profiles of perfusate from kidneys with immediate and delayed graft function. These may have a future role in viability assessment. Improved understanding of metabolism during storage may help target optimization strategies for deceased donor organs. The final part of this study describes the development of a porcine model of transplantation to test future hypotheses.
Supervisor: Not available Sponsor: Organ Recovery Systems
Qualification Name: Thesis (M.D.) Qualification Level: Doctoral
EThOS ID:  DOI: Not available
Keywords: R Medicine (General) ; RC Internal medicine ; RD Surgery